Akshay S Desai1, Brian L Claggett1, Milton Packer2, Michael R Zile3, Jean L Rouleau4, Karl Swedberg5, Victor Shi6, Martin Lefkowitz6, Randall Starling7, John Teerlink8, John J V McMurray9, Scott D Solomon10. 1. Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts. 2. Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas. 3. Medical University of South Carolina and Ralph H. Johnston Veterans Administration Medical Center, Charleston, South Carolina. 4. Institut de Cardiologie, Université de Montréal, Montreal, Quebec, Canada. 5. Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden; National Heart and Lung Institute, Imperial College, London, United Kingdom. 6. Novartis Pharmaceuticals Corporation, East Hanover, New Jersey. 7. Cardiology, Cleveland Clinic, Cleveland, Ohio. 8. Cardiology, Veterans Affairs Medical Center, San Francisco, California. 9. British Heart Foundation Cardiovascular Research Center, University of Glasgow, Glasgow, United Kingdom. 10. Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address: ssolomon@rics.bwh.harvard.edu.
Abstract
BACKGROUND:Patients with heart failure (HF) are at high risk for hospital readmission in the first 30 days following HF hospitalization. OBJECTIVES: This study sought to determine if treatment with sacubitril/valsartan (LCZ696) reduces rates of hospital readmission at 30-days following HF hospitalization compared with enalapril. METHODS: We assessed the risk of 30-day readmission for any cause following investigator-reported hospitalizations for HF in the PARADIGM-HF trial, which randomized 8,399 participants with HF and reduced ejection fraction to treatment withLCZ696 or enalapril. RESULTS: Accounting for multiple hospitalizations per patient, there were 2,383 investigator-reported HF hospitalizations, of which 1,076 (45.2%) occurred in subjects assigned to LCZ696 and 1,307 (54.8%) occurred in subjects assigned to enalapril. Rates of readmission for any cause at 30 days were 17.8% in LCZ696-assigned subjects and 21.0% in enalapril-assigned subjects (odds ratio: 0.74; 95% confidence interval: 0.56 to 0.97; p = 0.031). Rates of readmission for HF at 30-days were also lower in subjects assigned to LCZ696 (9.7% vs. 13.4%; odds ratio: 0.62; 95% confidence interval: 0.45 to 0.87; p = 0.006). The reduction in both all-cause and HF readmissions with LCZ696 was maintained when the time window from discharge was extended to 60 days and in sensitivity analyses restricted to adjudicated HF hospitalizations. CONCLUSIONS: Compared with enalapril, treatment with LCZ696 reduces 30-day readmissions for any cause following discharge from HF hospitalization.
RCT Entities:
BACKGROUND:Patients with heart failure (HF) are at high risk for hospital readmission in the first 30 days following HF hospitalization. OBJECTIVES: This study sought to determine if treatment with sacubitril/valsartan (LCZ696) reduces rates of hospital readmission at 30-days following HF hospitalization compared with enalapril. METHODS: We assessed the risk of 30-day readmission for any cause following investigator-reported hospitalizations for HF in the PARADIGM-HF trial, which randomized 8,399 participants with HF and reduced ejection fraction to treatment with LCZ696 or enalapril. RESULTS: Accounting for multiple hospitalizations per patient, there were 2,383 investigator-reported HF hospitalizations, of which 1,076 (45.2%) occurred in subjects assigned to LCZ696 and 1,307 (54.8%) occurred in subjects assigned to enalapril. Rates of readmission for any cause at 30 days were 17.8% in LCZ696-assigned subjects and 21.0% in enalapril-assigned subjects (odds ratio: 0.74; 95% confidence interval: 0.56 to 0.97; p = 0.031). Rates of readmission for HF at 30-days were also lower in subjects assigned to LCZ696 (9.7% vs. 13.4%; odds ratio: 0.62; 95% confidence interval: 0.45 to 0.87; p = 0.006). The reduction in both all-cause and HF readmissions with LCZ696 was maintained when the time window from discharge was extended to 60 days and in sensitivity analyses restricted to adjudicated HF hospitalizations. CONCLUSIONS: Compared with enalapril, treatment with LCZ696 reduces 30-day readmissions for any cause following discharge from HF hospitalization.
Authors: Agata Tymińska; Krzysztof Ozierański; Marcin Grabowski; Grzegorz Opolski; Paweł Balsam Journal: Cardiol J Date: 2020-07-10 Impact factor: 2.737
Authors: Kishan S Parikh; Steven J Lippmann; Melissa Greiner; Paul A Heidenreich; Clyde W Yancy; Gregg C Fonarow; Adrian F Hernandez Journal: Circulation Date: 2017-05-23 Impact factor: 29.690
Authors: Muthiah Vaduganathan; Brian L Claggett; Akshay S Desai; Stefan D Anker; Sergio V Perrone; Stefan Janssens; Davor Milicic; Juan L Arango; Milton Packer; Victor C Shi; Martin P Lefkowitz; John J V McMurray; Scott D Solomon Journal: J Am Coll Cardiol Date: 2019-11-11 Impact factor: 24.094
Authors: Joyce N Njoroge; Baljash Cheema; Andrew P Ambrosy; Stephen J Greene; Sean P Collins; Muthiah Vaduganathan; Alexandre Mebazaa; Ovidiu Chioncel; Javed Butler; Mihai Gheorghiade Journal: Heart Fail Rev Date: 2018-07 Impact factor: 4.214